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The objective of this study was to determine iodine nutrition status and whether iodine status differs across salt intake levels among a sample of women aged 18-45 years living in Samoa. A cross-sectional survey was completed and 24-hr urine samples were collected and assessed for iodine (n=152) and salt excretion (n=119). The median urinary iodine concentration (UIC) among the women was 88 μg/L (Interquartile range (IQR)=54-121 μg/L). 62% of the women had a UIC100 μg/L. The crude estimated mean 24-hr urinary salt excretion was 6.6 (standard deviation 3.2) g/day. More than two-thirds (66%) of the women exceeded the World Health Organization recommended maximum level of 5 g/day. No association was found between median UIC and salt excretion (81 μg/L iodine where urinary salt excretion=5 g/day versus 76 μg/L where urinary salt excretion5 g/day; p=0.4). Iodine nutrition appears to be insufficient in this population and may be indicative of iodine deficiency disorders in Samoan women. A collaborative approach in monitoring iodine status and salt intake will strengthen both programs and greatly inform the level of iodine fortification required to ensure optimal iodine intake as population salt reduction programs take effect.该研究旨在确定萨摩亚18-45 岁女性居民碘营养状况及碘状况是否随着盐摄入 水平的不同而不同。采用横断面调查，收集24 小时尿液样本，分析碘 （n=152）和盐排泄（n=119）。女性尿碘浓度（UIC）的中位数为88 μg/L （四分位间距（IQR）=54-121 μg/L）。62%的女性UIC100 μg/L。粗略估计 24 小时尿盐排泄量的均数为6.6（标准差3.2）克/天。超过2/3（66%）的妇女 尿盐排泄量超过世界卫生组织推荐的最高水平5 克/天。UIC 的中位数和盐排 泄之间无关系（尿盐排泄量=5 克/天的人群碘水平为81 μg/L，尿盐排泄量5 克/天的人群碘水平为76 μg/L；p=0.4）。萨摩亚妇女碘营养不足表明可能该 人群有碘缺乏病。部门间的协作将加强在监测碘营养状况和盐摄入量两个项目 和极大地告知碘强化所要求的水平，以确保人群减盐计划有效实施时有最佳的 碘摄入量。.

The prevalence of metabolic syndrome has reached epidemic levels in the Samoan Islands. In this cross-sectional study conducted in 2002-2003, dietary patterns were described among American Samoan (n = 723) and Samoan (n = 785) adults (> or =18 y) to identify neo-traditional and modern eating patterns and to relate these patterns to the presence of metabolic syndrome using Adult Treatment Panel III criteria. The neo-traditional dietary pattern, similar across both polities, was characterized by high intake of local foods, including crab/lobster, coconut products, and taro, and low intake of processed foods, including potato chips and soda. The modern pattern, also similar across both polities, was characterized by high intake of processed foods such as rice, potato chips, cake, and pancakes and low intake of local foods. The neo-traditional dietary pattern was associated with significantly higher serum HDL-cholesterol in American Samoa (P-trend = 0.05) and a decrease in abdominal circumference in American Samoa and Samoa (P-trend = 0.004 and 0.01, respectively). An inverse association was found with metabolic syndrome, although it did not reach significance (P = 0.23 in American Samoa; P = 0.13 in Samoa). The modern pattern was significantly positively associated with metabolic syndrome in Samoa (prevalence ratio = 1.21 for the fifth compared with first quintile; 95% CI: 0.93.1.57; P-trend = 0.05) and with increased serum triglyceride levels in both polities (P < 0.05). Reduced intake of processed foods high in refined grains and adherence to a neo-traditional eating pattern characterized by plant-based fiber, seafood, and coconut products may help to prevent growth in the prevalence of metabolic syndrome in the Samoan islands.

A tax on soft drinks is often proposed as a health promotion strategy for reducing their consumption and improving health outcomes. However, little is known about the processes and politics of implementing such taxes. We analysed four different soft drink taxes in Pacific countries and documented the lessons learnt regarding the process of policy agenda-setting and implementation. While local social and political context is critically important in determining policy uptake, these case studies suggest strategies for health promotion practitioners that can help to improve policy uptake and implementation. The case studies reveal interaction between the Ministries of Health, Finance and Revenue at every stage of the policy making process. In regard to agenda-setting, relevance to government fiscal priorities was important in gaining support for soft drink taxes. The active involvement of health policy makers was also important in initiating the policies, and the use of existing taxation mechanisms enabled successful policy implementation. While the earmarking of taxes for health has been widely recommended, the revenue may be redirected as government priorities change. Health promotion practitioners must strategically plan for agenda-setting, development and implementation of intersectoral health-promoting policies by engaging with stakeholders in finance at an early stage to identify priorities and synergies, developing cross-sectoral advocacy coalitions, and basing proposals on existing legislative mechanisms where possible.